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Medicare Program Options for Vets and Their Families.

Do you currently have healthcare benefits as a US veteran? You earned them! Thank you for your service. But what should you do about Medicare now that you are turning 65? How do Medicare and VA benefits work together? What about supplemental health insurance policies from private insurance companies? Your best choices with Medicare depend on the coverage you have now.

The bottom line is to keep in mind three different things. And those are that (1) VA plans only cover medical care at VA facilities which limits the selection of medical providers. However keep in mind (2), and that is that Medicare only pays for healthcare at Medicare assigned facilities and it does not pay for VA facilities. What all this means is (3), the federal government Medicare program does not overlap with the VA benefits that veterans get, and the VA benefit programs are entirely separate from what Medicare does. This makes some options the following:

Medicare Options with Tricare

Tricare covers active-duty and retired U.S. Armed Forces personnel and their dependents. It also is for former spouses or survivors if the service member has passed away. Note that the program was called the Civilian Health and Medical Program of the Uniformed Services, or CHAMPUS, in the past.

Tricare For Life is a plan that works as a secondary insurance to Medicare, so if you have Tricare for Life, you need to have Medicare Parts A and B; It is a prerequisite. Note there are some exceptions, in that retired military do not need Medicare supplement plans or Medigap plans, or drug coverage with Part D.

If you have Tricare, talk to the department that administers your benefits about the best plan for you. There are pharmacy plans, health insurance policies, vision insurance and more. Dial East 1-800-444-5445 or West 1-844-866-9378 . If you don't have Tricare, please read on.

Medicare Options with VA Benefits

Every honorably discharged veteran and every person retired from the military has VA benefits. The important thing to know about VA benefits is that they do not work or overlap with Medicare. This is why additional assistance and programs are usually a great option.

 

 

 

This means that if you go to see a VA doctor or you have a procedure done at a VA hospital, Medicare will NOT pick up any out-of-pocket costs charged. That can add to a household’s medical bills. And the VA will not pick up any costs if you see a healthcare provider who accepts Medicare. The point being that VA benefits only pay for doctors or hospitals in that VA system and Medicare health insurance only pays for health care at Medicare approved facilities.

If you have VA benefits, you have three options with regard to Medicare.

1. You can choose not to sign up for Medicare Part B. Note that Part A is free for people who have paid into Social Security for 40 quarters.

People new to Medicare will pay a premium. The cost will vary and tend to increase each year. But it will be about $150 per month. There is of course a deductible as well that applies to everyone, including veterans. Part B will have a deductible of about $200 each year. That's on top of the $1400+ deductible for Part A, for which most people don't have to pay a monthly premium.

If you are happy getting all your treatment with the VA, then why not just take the free Medicare Part A and ignore all the rest? It is an option. However for most veterans turning 65, that's not a good idea. If you do not sign up for Part B your health care expenses will be higher. The reason being that Medicare B pays for doctors and tests and all of the medical care as well as bills outside of a VA hospital. It someone does not pay for a Medicare option, this means that the veteran and their families will have higher medical bills.

 

 

 

 

Vets can sign up for the government health care option later though. But if a veteran does, then Medicare will charge you a penalty for signing up later and that penalty lasts years. The longer you wait, the higher the penalty will be.

If veteran or military service members benefits are cut in the future, or if you need to see a specialist outside the VA, or you need to get treatments at a facility not sponsored by the VA, you will need Medicare Part B. And to get it you will pay a penalty rate for the rest of your life. Also, some Medigap plans are only available to people who have pre-existing conditions if they sign up at age 65.

2. You can sign up for Medicare Parts A and B and skip any other coverage.

Many vets take this option. They want to be covered for doctors as well as hospitals outside of the VA system, but they are OK with Part B deductibles. Many who enroll are also fine with getting all their medications from the VA as there is good prescription coverage through the VA. Due to this, vets may not need Part D drug benefits. As the government does offer decent priced medications to veterans. However it can be explored, and read about Medicare Part D Coverage options.

But the only time to get a Medigap plan with no health questions asked is when you are new to Medicare. You could decide you need the extra coverage -- Part B can leave you with thousands of dollars of charges every year -- and not be able to get it because your health is not as good as it used to be.

3. Or you can sign up for Medicare Parts A and B and get lifetime coverage with a Medicare supplement plan.

That way you have the coverage you need everywhere you go. You can continue to use the VA, but you  will have coverage for any other medical emergencies. And you never have to be worried about being turned down later in life if you develop a serious health problem.

Summary and free help in navigating the options

As noted, the VA health benefit system is separate from Medicare and they provide different coverage at different hospitals, doctors, and facilities. They do not overlap. Then of course there are other supplemental and private health insurance options for veterans as well. It can and is often confusing.

 

 

 

 

Free guidance and assistance is available to help navigate this process. The VA benefits line is 1-800-827-1000. Many community action agencies also have health insurance policy navigators on site, and find a community action agency for assistance. Or try the toll free Medicare helpline at 1-800-633-4227.

 

By Jon McNamara

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